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The Multifarious Effects of Various Glaucoma Pharmacotherapy on Corneal Endothelium: A Narrative Review. Ophthalmol Ther 2023; 12:1457-1478. [PMID: 36930417 PMCID: PMC10164223 DOI: 10.1007/s40123-023-00699-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
Corneal endothelium is a single cell layer that is mainly responsible for maintaining corneal clarity. Endothelial damage secondary to toxicity, stress, or genetic predisposition are common and in conjunction with the low regenerative ability of the cells, making their preservation critical for maintaining visual acuity. Patients with glaucoma, who are estimated to be close to 80 million worldwide, have a plethora of reasons for developing endothelial damage, being exposed to a spectrum that extends from various medical and surgical interventions to the disease itself. The wide spectrum of glaucoma pharmacotherapy that has been recently extended by addition of newer classes of medications has been the focus of extensive research on its effects on corneal endothelium. Both basic and clinical research have attempted to shine a light on the complex mechanisms associated with the effects of glaucoma medication on corneal endothelium and to answer the important question as to whether these findings are clinically significant. The aim of this review is to summarize and present current literature of the various findings, both from in vivo and in vitro studies that have focused on the complex relationship between different classes of glaucoma medication and their effect on corneal endothelium.
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Chen XL, Fu YJ, Qu B, Wang YW, Tang X, Wang YH, Zhou GY, Lin MK, Shen JY, Yao J, Li SY, Wu MQ, Peng HZ, Lai MY, Wu RY, Zhang YN, Li Y, Wu XJ, Zhang MC, Guo SP, Sun XH. Safety profile of 0.0015% tafluprost eye drops in China: a post-marketing observational study. Int J Ophthalmol 2023; 16:108-114. [PMID: 36659941 PMCID: PMC9815987 DOI: 10.18240/ijo.2023.01.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/21/2022] [Indexed: 12/29/2022] Open
Abstract
AIM To investigate the treatment pattern and safety of tafluprost for glaucoma and ocular hypertension (OH) in clinical practice in China. METHODS This post-marketing observational study included patients who received tafluprost to lower intraocular pressure (IOP) within 30d between September 2017 and March 2020 in 20 hospitals in China. Adverse drug reactions (ADRs) during tafluprost treatment and within 30d after the treatment were collected. RESULTS A total of 2544 patients were included in this study, of them 58.5% (1488/2544) had primary open angle glaucoma (POAG), 21.9% (556/2544) had OH and 19.7% (500/2544) used tafluprost for other reasons. Of 359 ADRs occurred in 10.1% (258/2544) patients, and no serious adverse event occurred. The most common ADR was conjunctival hyperemia (128 ADRs in 124 patients, 4.9%). Totally 1670 participants (65.6%) combined tafluprost with carbonic anhydrase inhibitors (CAIs; 37.1%, 620/1670), sympathomimetics (33.5%, 559/1670), β-blockers (33.2%, 555/1670), other prostaglandin analogs (PGAs; 15.6%, 260/1670) and other eye drops (15.1%, 253/1670). The highest incidence of conjunctival hyperemia was noted in patients who received tafluprost in combination with other PGAs (23 ADRs in 23 patients, 8.8%, 23/260) and the lowest was in combination with CAIs (16 ADRs in 16 patients, 2.6%, 16/620). Tafluprost was applied in primary angle-closure glaucoma (41.6%, 208/500), after glaucoma surgery (17.8%, 89/500) and after non-glaucoma surgery (15.8%, 79/500). CONCLUSION Tafluprost is safe for POAG and OH, and tolerable when combined with other eye drops and under various clinical circumstances.
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Affiliation(s)
- Xue-Li Chen
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200000, China
| | - Yan-Jing Fu
- Department of Ophthalmology, Daqing Ophthalmologic Hospital, Daqing 163000, Heilongjiang Province, China
| | - Bo Qu
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning Province, China
| | - Ye-Wei Wang
- Department of Ophthalmology, Da Lian He Eye Specialist Hospital, Dalian 116000, Liaoning Province, China
| | - Xin Tang
- Department of Ophthalmology, Beijing Tongren Hospital, Beijing 100000, China
| | - Yu-Hong Wang
- Department of Ophthalmology, Xiamen Eye Center of Xiamen University, Xiamen 361000, Fujian Province, China
| | - Guo-Yi Zhou
- Department of Ophthalmology, Yueqing People's Hospital, Wenzhou 325600, Zhejiang Province, China
| | - Ming-Kai Lin
- Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
| | - Jing-Yuan Shen
- Department of Ophthalmology, Shengzhou Shen's Eye Hospital, Shaoxing 312400, Zhejiang Province, China
| | - Jin Yao
- Department of Ophthalmology, the Affiliated Eye Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu Province, China
| | - Su-Yan Li
- Department of Ophthalmology, Xuzhou No.1 Peoples Hospital, Xuzhou 221000, Jiangsu Province, China
| | - Miao-Qin Wu
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou 310000, Zhejiang Province, China
| | - Hua-Zong Peng
- Department of Ophthalmology, Wuhan Eyegood Ophthalmic Hospital, Wuhan 430014, Hubei Province, China
| | - Ming-Ying Lai
- Department of Ophthalmology, Shenzhen Eye Hospital, Shenzhen 518001, Guangdong Province, China
| | - Ren-Yi Wu
- Department of Glaucoma, Shanghai Heping Eye Hospital, Shanghai 200000, China
| | - Yi-Nong Zhang
- Department of Ophthalmology, Wuxi Second People's Hospital, Wuxi 214000, Jiangsu Province, China
| | - Yan Li
- Department of Ophthalmology, First Affiliated Hospital of Kunming Medical University, Kunming 650000, Yunnan Province, China
| | - Xiao-Jun Wu
- Department of Ophthalmology, Union Shenzhen Hospital (Nanshan Hospital), Shenzhen 518000, Guangdong Province, China
| | - Ming-Chang Zhang
- Department of Ophthalmology, Wuhan Union Hospital, Wuhan 430000, Hubei Province, China
| | - Su-Ping Guo
- Department of Ophthalmology, Shengyang He Eye Specialist Hospital, Shenyang 110000, Liaoning Province, China
| | - Xing-Huai Sun
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200000, China
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Menon MG, Goodkin ML. Triple Fixed-Combination Bimatoprost/Brimonidine/Timolol in Glaucoma and Ocular Hypertension in India: A Multicenter, Open-Label, Phase 3 Study. Clin Ophthalmol 2022; 16:3559-3569. [PMID: 36274674 PMCID: PMC9582300 DOI: 10.2147/opth.s369626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction To evaluate the intraocular pressure (IOP)-lowering efficacy and safety of a triple fixed-combination of bimatoprost, brimonidine, and timolol (TFC) in patients with glaucoma or ocular hypertension (OHT) treated with fixed-combination or unfixed brimonidine and timolol therapy (dual-combination therapy). Methods In this multicenter, open-label, phase 3 study, patients who received 4-8 weeks of dual-combination therapy twice daily and had an IOP >18 and <34 mmHg in at least one eye were switched (at baseline) to treatment with TFC twice daily for 12 weeks. At Weeks 4, 8, and 12 on TFC, IOP was assessed at Hours 0, 2, and 8. Primary efficacy variable: mean diurnal IOP change from baseline in the study eye at Week 12 (modified intent-to-treat [mITT] population). Sensitivity (per-protocol [PP] population) and subgroup (≤65 vs >65 years) analyses were performed. Safety, including adverse events (AEs), was assessed at each visit. Results Of 126 patients enrolled, 121 and 103 formed the mITT/safety and PP populations, including 109 (90.1%) and 94 (91.3%) who completed the study, respectively. In the mITT/safety population, mean age was 58.6 years. Patients had open-angle glaucoma (51.2%), angle-closure glaucoma with patent iridotomy (36.4%), and/or OHT (13.2%). At Week 12, the mean diurnal change in IOP from dual combination-treated baseline was statistically significant (P<0.001) with TFC in the mITT (-3.98 mmHg) and PP (-4.22 mmHg) populations. Results were similar at all visits, regardless of the age subgroup. The most frequent treatment-related AEs were conjunctival hyperemia (14.0%) and dry eye (4.1%); 5.8% of the patients discontinued treatment due to ocular AEs. Conclusion TFC offers a beneficial therapeutic alternative for patients with glaucoma or OHT whose IOP is not sufficiently controlled with dual-combination therapy. Safety and efficacy findings support those of published studies of TFC in primary open-angle glaucoma and OHT, despite differences in study designs.
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Affiliation(s)
- Meena G Menon
- Glaucoma Services, Sankara Eye Hospital, Bangalore, Karnataka, India,Correspondence: Meena G Menon, Glaucoma Services, Sankara Eye Hospital, Bangalore, Karnataka, India, Email
| | - Margot L Goodkin
- Ophthalmology Clinical Development, Allergan (an AbbVie Company), Irvine, CA, USA
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Aihara M, Lu F, Kawata H, Iwata A, Odani-Kawabata N. Twelve-month efficacy and safety of omidenepag isopropyl, a selective EP2 agonist, in open-angle glaucoma and ocular hypertension: the RENGE study. Jpn J Ophthalmol 2021; 65:810-819. [PMID: 34495425 DOI: 10.1007/s10384-021-00868-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/28/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To assess the long-term safety and efficacy of omidenepag isopropyl (OMDI) 0.002% (a first-in-class, selective, non-prostaglandin, prostanoid EP2 receptor agonist), alone or administered concomitantly with timolol 0.5%, in patients with open-angle glaucoma (OAG, including normal-tension and exfoliation glaucoma) or ocular hypertension (OHT). STUDY DESIGN Open-label, multicenter, Phase 3 study (NCT02822729). METHODS Patients aged ≥ 20 years, with OAG or OHT, and a baseline diurnal intraocular pressure (IOP) ≥ 16- < 22 mmHg (Group 1) or ≥ 22- ≤ 34 mmHg (Groups 2 and 3) were enrolled. All patients (N = 125) received OMDI 0.002% once daily. Group 3 also received timolol 0.5% twice daily. IOP was measured at baseline and at Weeks 2, 4, 8, 12, 26, 40, and 52. RESULTS Significant reductions in mean diurnal IOP from baseline occurred at every visit (P < 0.0001). Mean ± SE diurnal IOP reduction at Week 52 was -3.7 ± 0.3 mmHg (Group 1), -5.6 ± 0.5 mmHg (Group 2), and -8.4 ± 0.6 mmHg (Group 3). Most adverse events (AEs) were mild, and no serious treatment-related AEs were reported. Conjunctival hyperemia (incidence: monotherapy [Groups 1 and 2], 18.8%; concomitant [Group 3], 45.0%) and macular edema (ME)/cystoid macular edema (CME) (incidence: monotherapy, 11.8%; concomitant, 15.0%) occurred most frequently. All treatment-related ME/CME cases occurred in pseudophakic eyes and responded to standard-of-care treatment and study drug discontinuation. CONCLUSIONS In this study, OMDI 0.002%, alone or administered concomitantly with timolol 0.5%, resulted in sustained IOP reduction over 52 weeks in patients with OAG or OHT. Concomitant treatment resulted in increased efficacy and increased incidence of conjunctival hyperemia.
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Affiliation(s)
| | - Fenghe Lu
- Santen Inc., 6401 Hollis Street, Suite 125, Emeryville, CA, 94608, USA.
| | | | | | - Noriko Odani-Kawabata
- Santen Inc., 6401 Hollis Street, Suite 125, Emeryville, CA, 94608, USA.,Santen Pharmaceutical Co., Ltd., Osaka, Japan
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Chen JY, Le A, Caprioli J, Giaconi JA, Nouri-Mahdavi K, Law SK, Bonelli L, Coleman AL, Demer JL. Orbital Fat Volume After Treatment with Topical Prostaglandin Agonists. Invest Ophthalmol Vis Sci 2020; 61:46. [PMID: 32455434 PMCID: PMC7405708 DOI: 10.1167/iovs.61.5.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Topical prostaglandin analogs (PGAs) are common treatment for primary open-angle glaucoma (POAG) but reportedly may cause adnexal fat atrophy. We asked if patients with POAG treated with PGAs have abnormalities in orbital fat volume (OFV). Methods We studied 23 subjects with POAG who had never experienced intraocular pressure (IOP) exceeding 21 mm Hg and were treated long term with PGAs, in comparison with 21 age-matched controls. Orbital volume, non-fat orbital tissue volume, and OFV were measured using high-resolution magnetic resonance imaging. Results Subjects with POAG had been treated with PGAs for 39 ± 19 months (SD) and were all treated within the 4 months preceding study. In the region from trochlea to orbital apex, OFV in POAG was significantly less at 9.8 ± 1.9 mL than in the control subjects at 11.1 ± 1.3 mL (P = 0.019). However, between the globe-optic nerve junction (GONJ) and trochlea, OFV was similar in both groups. Width and cross sectional area of the bony orbit were significantly smaller in POAG than in controls (P < 0.0001). Posterior to the GONJ, the average orbital cross-sectional area was 68.2 mm2 smaller, and the orbital width averaged 1.5 mm smaller throughout the orbit, in patients with POAG than in controls. Conclusions Patients with POAG who have been treated with PGAs have lower overall OFV than controls, but OFV in the anterior orbit is similar in both groups. Lower overall OFV in POAG may be a primary association of this disorder with a horizontally narrower bony orbit, which may be a risk factor for POAG at nonelevated IOPs.
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Abstract
Glaucoma is the main cause of irreversible blindness in the world. Latanoprost - an ester prodrug of prostaglandin F2α (PGF2α) - was the first prostaglandin analogue used in the treatment of glaucoma. The present review shows that latanoprost is the most balanced prostaglandin analogue in terms of efficacy-safety. Its use improves the quality of life of glaucoma patients, provides reliable IOP reduction, has high patient compliance, and helps with the long-term preservation of visual functions. The review also reveals the possibility of long-term (more than five years) use of the drug, as well as effective combined treatment using latanoprost and beta-blockers, considers the pediatric use of latanoprost, and discusses its neuroprotective properties.
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Affiliation(s)
- N I Kurysheva
- A.I. Burnazyan Federal Medical and Biophysical Center of FMBA, Moscow, Russia
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